Ureteral calculi in patients with flank pain: correlation of plain radiography with unenhanced helical CT.

Levine, Jessica L.S.; Neitlich, Jeffrey D.; Verga, Marco; Dalrymple, Neal C.; Smith, Robert C.

doi:10.1148/radiology.204.1.9205218

Cited by 241 publications

(99 citation statements)

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“…There are recent concerns regarding the radiation exposure during CT examinations and its indiscriminate use. Moreover, many patients may receive an additional radiation dose during follow-up studies (if a calculus is not expelled) or with new episode of colic and the cumulative effective doses of radiation from imaging procedures increased with advancing age (8,9).…”

Section: Discussionmentioning

confidence: 99%

Value of color doppler ultrasound, kub and urinalysis in diagnosis of renal colic due to ureteral stones

Abdel-Gawad¹,

Kadasne²,

Anjikar³

et al. 2014

Int. braz j urol.

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Section: Discussionmentioning

confidence: 99%

Value of color doppler ultrasound, kub and urinalysis in diagnosis of renal colic due to ureteral stones

Abdel-Gawad¹,

Kadasne²,

Anjikar³

et al. 2014

Int. braz j urol.

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“…With the use of NCMSCT in the diagnosis of urinary tract stone disease, especially nonopaque stones can be identified more easily and accurately (Smith et al, 1995;Tublin et al, 2002). Besides providing information about the size, localization and chemical structure of stones, NCMSCT can also display both urinary and non-urinary tract pathologies (Levine et al, 1997;Saw et al, 2000). The main disadvantage of using a NCMSCT in patients with urinary tract stone disease is that it exposes patients to a relatively high radiation due to the use of X-rays.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of hydronephrotic kidney parenchymal density by non-contrast multislice computed tomography

Yildirim¹,

Açıkgöz²,

Danacı³

et al. 2012

jecm

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ÖZETUzun süren üreteral obstrüksiyonun böbrek fonksiyon kaybına neden olduğu iyi bilinmektedir. Üriner sistem taşına bağlı herhangi bir obstrüksiyonun kontrastsız çok kesitli bilgisayarlı tomografi (KÇKBT) ile belirlenmesi tedavi zamanlaması hakkında karar vermek açısından çok önemlidir. Çalişmamızda deneysel hidronefroz oluşturulan ratlarda renal parankim dansitesinde meydana gelen değişiklikler KÇKBT ile değerlendirildi. Bu çalışmada sol üreterlerinde total veya parsiyel obstrüksiyon oluşturulmuş SpraqueDawley ratların böbrek parankim dansiteleri deneyin 1.,3. ve 30. günlerinde KÇKBT ile değerlendirilerek, sham ve kontrol grubu ratların böbrek parankim dansiteleri ile karşılaştırıldı. Parsiyel üreteral obstrüksiyon oluşturulmuş ratların böbrek parankim dansiteleri ile kontrol grubunun böbrek parankim dansiteleri arasında anlamlı bir fark olmadığı saptandı. Bununla birlikte total üreteral obstrüksiyon oluşturulmuş ratların böbrek parankim dansitelerinin karşı taraf böbrekleri ve kontrol grubu ile karşılaştırıldığında anlamlı olarak azaldığı saptandı. Böbrek üst, orta ve alt segmentlerinin ortalama dansite değerleri benzerdi. Elde edilen bu bulguların insanlarda üreter obstrüksiyonun sonuçlarının değerlendirilmesinde yararlı olabileceğini düşünmekteyiz. KÇKBT değerlendirilmesinde renal parankim dansitesinin azalması renal parankimal hasarın bir göstergesi olabilir.J. Exp. Clin. Med., 2012; 29:215-220 It is well known that a prolonged ureteral obstruction leads to function loss of the congested kidney. Determining whether kidney stones cause any obstruction by noncontrast multislice CT is crucial for deciding about the timing of treatment. In our study we evaluated by Non-Contrast Multislice Computed Tomography (NCMSCT) detectable reliable changes of the density of the renal parenchyma in rats with artificial hydronephrosis. We made total or partial obstruction to left ureters of Spraque-Dawley rats, and applied sham operation to control groups. Using NCMSCT we measured the renal average parenchyma densities in the first, third and thirteenth days of operation. There was no significant difference between the parenchyma density of partial obstructed group and control group. However the parenchyma density in totally obsructed kidneys has significantly decreased compared to the contralateral kidneys and control group. In this group the duration of the obstruction correlated with signifıcantly decreased parenchyma density. The average density values of the upper, middle and lower renal segments were similar. We assume that our results can be useful in the evaluation of the consequences of the ureteral obstruction. The decrease of the parenchyma density evaluated in NCMSCT could be an important indicator of the renal parenchymal damages.

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“…20,21 Thus, unenhanced helical CT is currently the imaging test of choice for evaluating patients with acute fl ank pain for whom the clinical diagnosis is uncertain. [22][23][24][25][26][27][28][29] In the CT evaluation of ureteral calculi, the agreement between the group of senior residents and the consensus among the abdominal radiologists were very good, as shown in Table 3. The interobserver agreement for identifying the ureteral stone was almost perfect (k = 0.81).…”

Section: Ureterovesical 47%mentioning

confidence: 92%

Comparison between ultrasound and noncontrast helical computed tomography for identification of acute ureterolithiasis in a teaching hospital setting

et al. 2007

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CONTEXT AND OBJECTIVE: Recent studies have shown noncontrast computed tomography (NCT) to be more effective than ultrasound (US) for imaging acute ureterolithiasis. However, to our knowledge, there are few studies directly comparing these techniques in an emergency teaching hospital setting. The objectives of this study were to compare the diagnostic accuracy of US and NCT performed by senior radiology residents for diagnosing acute ureterolithiasis; and to assess interobserver agreement on tomography interpretations by residents and experienced abdominal radiologists. DESIGN AND SETTING: Prospective study of 52 consecutive patients, who underwent both US and NCT within an interval of eight hours, at Hospital São Paulo. METHODS: US scans were performed by senior residents and read by experienced radiologists. NCT scan images were read by senior residents, and subsequently by three abdominal radiologists. The interobserver variability was assessed using the kappa statistic. RESULTS: Ureteral calculi were found in 40 out of 52 patients (77%). US presented sensitivity of 22% and specificity of 100%. When collecting system dilatation was associated, US demonstrated 73% sensitivity, 82% specificity. The interobserver agreement in NCT analysis was very high with regard to identification of calculi, collecting system dilatation and stranding of perinephric fat. CONCLUSIONS: US has limited value for identifying ureteral calculi in comparison with NCT, even when collecting system dilatation is present. Residents and abdominal radiologists demonstrated excellent agreement rates for ureteral calculi, identification of collecting system dilatation and stranding of perinephric fat on NCT.

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Ureteral calculi in patients with flank pain: correlation of plain radiography with unenhanced helical CT.

Abstract: Plain radiography is of limited value for aiding the diagnosis of ureteral stones. All patients with acute flank pain for whom radiologic imaging is recommended can directly undergo unenhanced helical CT; plain radiographs need not be obtained first.

Cited by 241 publications

References 0 publications

Value of color doppler ultrasound, kub and urinalysis in diagnosis of renal colic due to ureteral stones

Value of color doppler ultrasound, kub and urinalysis in diagnosis of renal colic due to ureteral stones

Evaluation of hydronephrotic kidney parenchymal density by non-contrast multislice computed tomography

Comparison between ultrasound and noncontrast helical computed tomography for identification of acute ureterolithiasis in a teaching hospital setting

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